Effects of frequency, intensity, duration and volume of walking interventions on CVD risk factors: a systematic review and meta-regression analysis of randomised controlled trials among inactive healthy adults

Oja, Pekka; Kelly, Paul; Murtagh, Elaine; Murphy, Marie; Foster, Charlie; Titze, Sylvia

doi:10.1136/bjsports-2017-098558

Cited by 123 publications

(119 citation statements)

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“…For BMI and waist size, reductions were greater in the high one-minute, 30-min and 60-min cadence quartiles than the moderate quartile. Analysis of randomized controlled trial (RCT) data has been less conclusive on this point, with systematic reviews of walking interventions reporting a lack of evidence demonstrating a dose-response effect [39,40].…”

Section: Discussionmentioning

confidence: 99%

Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population

Sumner

Uijtdewilligen

Yee

et al. 2020

IJERPH

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The health benefits of objectively measured physical activity volume versus intensity have rarely been studied, particularly in non-western populations. The aim of this study was to investigate the association between cardiometabolic risk factors and stepping activity including; volume (step count), intensity (cadence) or inactivity (zero-steps/minute/day), in a multi-ethnic Asian population. Participants clinical data was collected at baseline and their physical activity was monitored for seven days, using an accelerometer (Actigraph GT3X+) in 2016. Tertiles (low, moderate, high) of the mean daily step count, peak one-minute, 30-min, 60-min cadences and time/day spent at zero-steps/minute were calculated. Adjusted linear regressions explored the association between stepping activity tertiles and cardiometabolic risk factors. A total of 635 participants (41% male, 67% Chinese, mean age 48.4 years) were included in the analyses. The mean daily step count was 7605 (median daily step count 7310) and 7.8 h of awake time per day were spent inactive (zero-steps/minute). A greater number of associations were found for step intensity than volume. Higher step intensity was associated with reduced body mass index (BMI), waist circumference, blood pressures and higher high-density lipoprotein (HDL). Future health promotion initiatives should consider the greater role of step intensity to reduce cardiometabolic risk.

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Section: Discussionmentioning

confidence: 99%

Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population

Sumner

Uijtdewilligen

Yee

et al. 2020

IJERPH

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“…This Special Issue includes three extended editorials,3–5 three systematic reviews6–8 (including one meta-analysis6), one narrative review, one scoping review9 and one individual participant pooled analysis 10. World Health Organization Program Leader Fiona Bull and the co-author of the 1997 review Adrianne Hardman3 provide the historical context.…”

Section: Comprehensive Update On Walking and Health In This Issuementioning

confidence: 99%

“…The huge popularity of fitness trackers13 has been mostly founded on people’s desire to monitor the number of steps in daily life, but the pace of those steps is often ignored. Oja and colleagues6 meta-analysed 37 randomised controlled trials that examined the effect of walking characteristics (amount, frequency and intensity) on an array of cardiovascular risk markers to determine whether there is a dose–response effect. In other words, is ‘more or faster (walking) the better’ for cardiovascular health?…”

Section: Ok But How Much and How Fast?mentioning

confidence: 99%

What Hippocrates called ‘Man’s best medicine’: walking is humanity’s path to a better world

Stamatakis¹,

Hamer²,

Murphy³

2018

Br J Sports Med

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“…Firstly, walking is safe and easy to integrate in everyday life (8). Secondly, walking has bene cial effects on several CVD risk factors (9,10), and reduces the risk of all-cause and CVD-speci c mortality (11,12).…”

Section: Introductionmentioning

confidence: 99%

“…Walking may hence be one of the most evident physical activity types to promote on a population level to prevent CVD. However, because the age-related decline in maximal aerobic capacity (VO 2 max) (13,14) leads to a higher relative intensity during walking among elderly, the preventive potential of walking may be highest among older individuals (9). Younger individuals may therefore need to engage in high-intensity physical activity (HIPA) types such as cycling and running to achieve a similar relative intensity and accompanying health bene ts (11,(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Can we walk away from cardiovascular disease risk or do we have to ‘huff and puff’? A cross-sectional compositional accelerometer data analysis among adults and older adults in the Copenhagen City Heart Study

Johansson

Søgaard

Prescott

et al. 2020

Preprint

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Background: It is unclear whether walking can decrease cardiovascular disease (CVD) risk or if high intensity physical activity (HIPA) is needed, and whether the association is modified by age. We investigated how sedentary behaviour, walking, and HIPA, were associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) among adults and older adults in a general population sample using compositional data analysis. Specifically, the measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) HIPA. Methods: Cross-sectional data from the fifth examination of the Copenhagen City Heart Study was used. Using the software Acti4, we estimated daily time spent in physical behaviours from accelerometer data worn 24 h/day for 7 days (i.e., right frontal thigh and iliac crest; median wear time: 6 days, 23.8 h/day). SBP, WC, and LDL-C were measured during a physical examination. Inclusion criteria were ≥5 days with ≥16 h of accelerometer recordings per day, and no use of antihypertensives, diuretics or cholesterol lowering medicine. The 24-hour physical behaviour composition consisted of sedentary behaviour, standing, moving, walking, HIPA (i.e., sum of climbing stairs, running, cycling and rowing), and time in bed. We used fitted values from linear regression models to predict the difference in outcome given the investigated time reallocations relative to the group-specific mean composition. Results: Among 1053 eligible participants, we found an interaction between the physical behaviour composition and age. Age-stratified analyses (i.e., </≥65 years; 773 adults, 280 older adults) indicated that less sedentary behaviour and more walking was associated with lower SBP among older adults only. For less sedentary behaviour and more HIPA, the results i) indicated an association with lower SBP irrespective of age, ii) showed an association with a smaller WC among adults, and iii) showed an association with a lower LDL-C in both age groups. Conclusions: Less sedentary behaviour and more walking seems to be associated with lower CVD risk among older adults, while HIPA types are associated with lower risk among adults. Therefore, to reduce CVD risk, the modifying effect of age should be considered in future physical activity-promoting initiatives.

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Effects of frequency, intensity, duration and volume of walking interventions on CVD risk factors: a systematic review and meta-regression analysis of randomised controlled trials among inactive healthy adults

Abstract: CRD42016039409.

Cited by 123 publications

References 50 publications

Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population

Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population

What Hippocrates called ‘Man’s best medicine’: walking is humanity’s path to a better world

Can we walk away from cardiovascular disease risk or do we have to ‘huff and puff’? A cross-sectional compositional accelerometer data analysis among adults and older adults in the Copenhagen City Heart Study

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